Credit Characteristics and Business Performance: A Survey of Women owned Microenterprises in Tanzania

This article provides assessment of the effects of four credit characteristics including size, interest rate, repayment period and borrowing experience on business performance. The article makes use of survey data collected from 217 women microcredit clients from Arusha, Dar es Salaam and Mwanza regions in Tanzania.  Bivariate correlation analysis was used to find out specific effect of each of those four credit characteristics on three business performance measures namely total sales revenue, net profit and business net worth. The combined effect of all four credit characteristics on business performance was estimated by a multiple linear regression model. The findings revealed that size of credit was positively correlated with total sales revenue and business net worth at significant level. Interest rate was negatively correlated with all three measures of business performance at significant level. It was also found out that repayment period was positively correlated with all three business performance indicators at significant level. Furthermore, the study established that borrowing experience was positively correlated with total sales revenue at significant level but not with other two indicators. The model accounted for 25% of sales revenue, 9% of net profit and 28% of business net worth

HIV risk behaviours, perceived severity of drug use problems, and prior treatment experience in a sample of young heroin injectors in Dar es Salaam, Tanzania.

Interviews were conducted with 203 male and 95 female heroin injectors aged 17 to 25 in Dar es Salaam, Tanzania. Nearly one-quarter of participants reported injecting with needles used by someone else. Few reported cleaning needles with bleach. Multiple sexual partnerships, unprotected sex, and trading sex for money were especially present among women, the majority (55%) of whom was HIV seropositive. Self reports suggest the presence of heroin dependence among users. While most participants expressed a desire to quit their use, only 14 (5%) had been in treatment. There appears to be a large unmet need for heroin use treatment. These findings need to be considered in light of a potential forthcoming wave of heroin injection in sub-Saharan Africa.Key Words: HIV, injection drug use, Africa, heroin, drug dependence treatmen

Credit Characteristics and Business Performance: A Survey of Women owned Microenterprises in Tanzania

This article provides assessment of the effects of four credit characteristics including size, interest rate, repayment period and borrowing experience on business performance. The article makes use of survey data collected from 217 women microcredit clients from Arusha, Dar es Salaam and Mwanza regions in Tanzania. Bivariate correlation analysis was used to find out specific effect of each of those four credit characteristics on three business performance measures namely total sales revenue, net profit and business net worth. The combined effect of all four credit characteristics on business performance was estimated by a multiple linear regression model. The findings revealed that size of credit was positively correlated with total sales revenue and business net worth at significant level. Interest rate was negatively correlated with all three measures of business performance at significant level. It was also found out that repayment period was positively correlated with all three business performance indicators at significant level. Furthermore, the study established that borrowing experience was positively correlated with total sales revenue at significant level but not with other two indicators. The model accounted for 25% of sales revenue, 9% of net profit and 28% of business net worth

The hepatitis C cascade of care in people who inject drugs in Dar es Salaam, Tanzania

The World Health Organisation has recently called for hepatitis C virus (HCV) elimination and has identified people who inject drugs (PWID) as a key population to scale‐up screening and linkage to care. This study reports the cascade of care for HCV in PWID attending the largest opioid substitution treatment (OST) clinic in Dar‐es‐Salaam, Tanzania. Between February 2011 and March 2016, HCV serology for all PWID registered at the Muhimbili National Hospital OST clinic, Dar‐es‐Salaam were obtained from records. In 2015 consecutive HCV‐seropositive PWID were invited to undergo a clinical evaluation including epidemiological questionnaire, liver stiffness measurement (Fibroscan) and virological analysis (HCV RNA viral load and genotyping). During the study period, 1,350 persons registered at the OST clinic: all had a HCV serology including 409 (30%) positive results. Among the HCV‐seropositive individuals, 207 (51%) were active attenders and 153 (37%) were enrolled for clinical assessment: 141 (92%) were male, median age: 38 years (IQR 34‐41), and 65 (44%) were co‐infected with HIV; 116 patients (76%) had detectable HCV RNA, with genotypes 1a (68%) and 4a (32%); 21 (17%) had clinically significant fibrosis (≥F2) and 6 (5%) had cirrhosis (F4). None were offered HCV treatment. Chronic hepatitis C among PWID enrolled in the OST centre in Dar‐es‐Salaam is frequent, but its continuum of care is insufficient; integration of HCV diagnosis and treatment should form a part of OST intervention in PWID in Tanzania

High burden of tuberculosis infection and disease among people receiving medication-assisted treatment for substance use disorder in Tanzania

OBJECTIVE: To determine the prevalence of tuberculosis (TB) disease and infection as well as incident TB disease among people who use drugs (PWUD) attending Medication Assisted Treatment (MAT) clinics in Dar-es-Salaam, Tanzania. METHODS: In this prospective cohort study, a total of 901 consenting participants were enrolled from November 2016 to February 2017 and a structured questionnaire administered to them through the open data kit application on android tablets. Twenty-two months later, we revisited the MAT clinics and reviewed 823 of the 901 enrolled participant's medical records in search for documentation on TB disease diagnosis and treatment. Medical records reviewed included those of participants whom at enrolment were asymptomatic, not on TB disease treatment, not on TB preventive therapy and those who had a documented tuberculin skin test (TST) result. RESULTS: Of the 823 medical records reviewed 22 months after enrolment, 42 had documentation of being diagnosed with TB disease and initiated on TB treatment. This is equivalent to a TB disease incidence rate of 2,925.2 patients per 100,000 person years with a total follow up time of 1,440 person-years. At enrolment the prevalence of TB disease and TB infection was 2.6% and 54% respectively and the HIV prevalence was 44% and 16% among females and males respectively. CONCLUSION: PWUD attending MAT clinics bear an extremely high burden of TB and HIV and are known to have driven TB epidemics in a number of countries. Our reported TB disease incidence is 12 times that of the general Tanzanian incidence of 237 per 100,000 further emphasizing that this group should be prioritized for TB screening, testing and treatment. Gender specific approaches should also be developed as female PWUDs are markedly more affected with HIV and TB disease than male PWUDs

In-field evaluation of Xpert® HCV viral load fingerstick assay in people who inject drugs in Tanzania

Background Although novel hepatitis C (HCV) RNA point-of-care technology has the potential to enhance diagnosis in resource-limited settings, very little real-world validation of their utility exists. We evaluate the performance of HCV RNA quantification using the Xpert® HCV Viral Load Fingerstick assay (Xpert® HCV VL Fingerstick assay) as compared to the WHO pre-qualified plasma Xpert® HCV viral load assay among people who inject drugs (PWID) attending an opioid agonist therapy (OAT) clinic in Dar-es-Salaam, Tanzania. Methods Between December 2018 and February 2019 consecutive HCV seropositive PWID attending the OAT clinic provided paired venous and finger-stick samples for HCV RNA quantification. These were processed on-site using the GeneXpert® platform located at the Central tuberculosis reference laboratory. Results A total of 208 out of 220 anti-HCV positive participants recruited (94.5%) had a valid Xpert® HCV VL result available; 126 (61%; (95% CI 53.8-67.0) had detectable and quantifiable HCV RNA. 188 (85%) had paired plasma and finger-stick whole blood samples; the sensitivity and specificity for the quantification of HCV RNA levels were 99.1% and 98.7% respectively. There was an excellent correlation (R2=0.95) and concordance (mean difference 0.13 IU/mL, (95% CI -0.9 to 0.16 IU/mL) in HCV RNA levels between plasma samples and finger-stick samples. Conclusion This study found excellent performance of the Xpert® HCV VL Fingerstick assay for HCV RNA detection and quantification in an African-field setting. Its clinical utility represents an important watershed in overcoming existing challenges to HCV diagnosis, which should play a crucial role in HCV elimination in Africa

Polyphenolic compounds with anti-AGEs activity from three Clusiaceae plants

Aim: This study focused on finding molecules with inhibitory effects on Advanced Glycation End-products (AGEs) formation from Tanzanian some Clusiaceae plant species Study Design: Field study and Laboratory experimental tests. Place and Duration of Study: Institute of Traditional Medicine, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania and PRES LUNAM, Université d’Angers, EA 921 SONAS, 16 Bd Daviers, 49045 Angers, France, between June 2011 and July 2013. Methodology: Three Clusiaceae plant species (Garcinia semseii, G. volkensii and Allanblackia ulugurensis) were collected and dried in the field with the assistance of a botanist. Extraction and concentration of plant samples to obtain crude extracts were done in the laboratory following standard procedures. The isolation of the phenolic compounds was carried out by using normal phase column chromatography as well as High-performance liquid chromatography (HPLC). The isolated compounds were tested for anti-AGE activity using the in vitro automated assay. Results: Two polyphenolic compounds exhibiting phloroglucinol moieties [e.g. polyprenylated benzophenones, such as guttiferone F, 2 (18 mg)] or biflavonoids [such as morellof lavone, 1 (22 mg)] were isolated and identified from A. ulugurensis and G. volkensis respectively. The results further indicated that compound 1 is an excellent inhibitor of AGE formation exhibiting an IC 50 values of 78 and 64 μM at wavelength of 370/440 (vesperlysines-like AGEs) and 335/385 (pentosidine-like AGEs) respectively. Conclusion: Plants belonging to the Clusiaceae family commonly used in Tanzanian traditional medicine need to be considered as a potential source of molecules exhibiting pharmacological activities such as anti-AGE activity. Morelloflavone (1) and other biflavonoids prove to be very good anti-AGE compounds using our automated screening assay. Hence, our automated in vitro assay allows a fast, effective and quite inexpensive screening of natural compounds and can therefore be applied to high throughput screening project

Socio-economic and partner relationship factors associated with antenatal depressive morbidity among pregnant women in

Depression during pregnancy may negatively influence social functioning, birth outcomes and postnatal mental health. A cross-sectional analysis of the baseline survey of a prospective study was undertaken with an objective of determining the prevalence and socio-demographic factors associated with depressive morbidity during pregnancy in a Tanzanian peri-urban setting. Seven hundred and eighty seven second to third trimester pregnant women were recruited at booking for antenatal care at two primary health care clinics. Prenatal structured interviews assessed socio-economic, quality of partner relationships and selected physical health measures. Depressive symptoms were measured at recruitment and three and eight months postpartum using the Kiswahili version of the Hopkins Symptom Checklist. Completed antenatal measures available for 76.2% participants, showed a 39.5% prevalence of depression. Having a previous depressive episode (OR 4.35,

Potential opportunities and challenges of deploying next generation sequencing and CRISPR-cas systems to support diagnostics and surveillance towards malaria control and elimination in Africa

Recent developments in molecular biology and genomics have revolutionized biology and medicine mainly in the developed world. The application of next generation sequencing (NGS) and CRISPR-Cas tools is now poised to support endemic countries in the detection, monitoring and control of endemic diseases and future epidemics, as well as with emerging and re-emerging pathogens. Most low and middle income countries (LMICs) with the highest burden of infectious diseases still largely lack the capacity to generate and perform bioinformatic analysis of genomic data. These countries have also not deployed tools based on CRISPR-Cas technologies. For LMICs including Tanzania, it is critical to focus not only on the process of generation and analysis of data generated using such tools, but also on the utilization of the findings for policy and decision making. Here we discuss the promise and challenges of NGS and CRISPR-Cas in the context of malaria as Africa moves towards malaria elimination. These innovative tools are urgently needed to strengthen the current diagnostic and surveillance systems. We discuss ongoing efforts to deploy these tools for malaria detection and molecular surveillance highlighting potential opportunities presented by these innovative technologies as well as challenges in adopting them. Their deployment will also offer an opportunity to broadly build in-country capacity in pathogen genomics and bioinformatics, and to effectively engage with multiple stakeholders as well as policy makers, overcoming current workforce and infrastructure challenges. Overall, these ongoing initiatives will build the malaria molecular surveillance capacity of African researchers and their institutions, and allow them to generate genomics data and perform bioinformatics analysis in-country in order to provide critical information that will be used for real-time policy and decision-making to support malaria elimination on the continent

Age-related differences in socio-demographic and behavioral determinants of HIV testing and counseling in HPTN 043/NIMH Project Accept

Youth represent a large proportion of new HIV infections worldwide, yet their utilization of HIV testing and counseling (HTC) remains low. Using the post-intervention, cross-sectional, population-based household survey done in 2011 as part of HPTN 043/NIMH Project Accept, a cluster-randomized trial of community mobilization and mobile HTC in South Africa (Soweto and KwaZulu Natal), Zimbabwe, Tanzania and Thailand, we evaluated age-related differences among socio-demographic and behavioral determinants of HTC in study participants by study arm, site, and gender. A multivariate logistic regression model was developed using complete individual data from 13,755 participants with recent HIV testing (prior 12 months) as the outcome. Youth (18–24 years) was not predictive of recent HTC, except for high-risk youth with multiple concurrent partners, who were less likely (aOR 0.75; 95% CI 0.61–0.92) to have recently been tested than youth reporting a single partner. Importantly, the intervention was successful in reaching men with site specific success ranging from aOR 1.27 (95% CI 1.05–1.53) in South Africa to aOR 2.30 in Thailand (95% CI 1.85–2.84). Finally, across a diverse range of settings, higher education (aOR 1.67; 95% CI 1.42, 1.96), higher socio-economic status (aOR 1.21; 95% CI 1.08–1.36), and marriage (aOR 1.55; 95% CI 1.37–1.75) were all predictive of recent HTC, which did not significantly vary across study arm, site, gender or age category (18–24 vs. 25–32 years)